San Francisco Chronicle Examines Potential Effects of Democratic-Controlled Congress on CARE Act, PEPFAR Reauthorization

The San Francisco Chronicle on Sunday examined the potential effects of the Democratic-controlled Congress on the reauthorization of the Ryan White CARE Act -- which provides funding for HIV/AIDS programs in the U.S. -- and the President's Emergency Plan for AIDS Relief (Russell, San Francisco Chronicle, 11/12). Congress last month adjourned without the Senate passing a measure to reauthorize the CARE Act. Five senators, including some from New Jersey and New York, blocked Senate consideration of a House-approved bill (HR 6143) sponsored by Rep. Mary Bono (R-Calif.) that would change CARE Act funding formulas so that rural areas experiencing increasing numbers of HIV/AIDS cases receive higher funding amounts, which would decrease funding allocated to urban areas. Some legislators from states with large urban areas -- including California, New Jersey and New York -- have opposed measures that would change CARE Act funding formulas, saying they could harm HIV/AIDS programs in areas with higher HIV prevalence (Kaiser Daily HIV/AIDS Report, 11/1). Although the Bush administration might "push the bill through the lame-duck session," changes to CARE Act funding formulas proposed by Republicans likely will be "shelved and redrafted" when Congress reconvenes in January 2007, the Chronicle reports. In addition, incoming House Speaker Nancy Pelosi (D-Calif.) is unlikely to allow changes to funding formulas that would decrease funding allocated to urban areas, according to the Chronicle. Some HIV/AIDS advocates have said that an additional $200 million in CARE Act funding would fully fund programs in urban areas, but the budget deficit likely will make increased funding difficult, the Chronicle reports.

PEPFAR
PEPFAR in 2007 is scheduled to be reauthorized amid a "big fight over abstinence-only programs," the Chronicle reports. Although members of the Democratic Party in general "approve" of PEPFAR, they "strenuously oppose" its abstinence funding requirements, according to the Chronicle (San Francisco Chronicle, 11/12). By law, at least one-third of HIV prevention funds that countries receive through PEPFAR -- a $15 billion, five-year program -- must be used for abstinence-until-marriage programs (Kaiser Daily HIV/AIDS Report, 9/8). Democrats also might attempt to prevent rules that require relief recipients to sign a pledge opposing commercial sex work and that limit condom distribution to high-risk groups, the Chronicle reports. In addition, Democrats might attempt to rewrite PEPFAR rules and expand the program so that contributions to the Global Fund To Fight AIDS, Tuberculosis and Malaria can be increased. Although Republicans likely will oppose changes to PEPFAR's abstinence funding requirements, they might agree to funding increases, according to the Chronicle (San Francisco Chronicle, 11/12).